2013～2016年哈尔滨某医院血培养分离菌的分布及耐药性分析

Distribution and antimicrobial resistance of pathogens isolated from blood culture from 2013 to 2016 in a hospital of Harbin

目的研究血流感染病原菌的分布及对抗菌药物的耐药性。方法对2013年1月~2016年12月送检的血标本进行培养、鉴定和药敏试验,并对主要病原菌的分布和药敏结果进行统计分析。结果72 783份血培养标本共分离病原菌6 802株,分离率为9.3%,其中革兰阴性杆菌占57.3%,革兰阳性球菌占39.9%,真菌占2.8%。分离率居前5位的依次为凝固酶阴性葡萄球菌1 677株(24.6%)、大肠埃希菌1 099(16.9%)、肺炎克雷伯菌878(12.9%)、鲍曼不动杆菌474株(7.0%)和布鲁菌361(5.3%)。肺炎克雷伯菌分离率逐年增高,对亚胺培南的耐药率由2013年的2.2%上升至2016年的9.9%。鲍曼不动杆菌分离率逐年增高,对头孢哌酮/舒巴坦的耐药率为60%左右,对头孢吡肟和亚胺培南的耐药率为80%左右。结论应合理应用抗菌药物,并加强医院感染控制措施抑制耐药菌传播。

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood culture. Methods Blood specimens from patients between January 2013 and December 2016 were cultured, identified and performed antimicrobial susceptibility tes- ting, and the major pathogens and the antimicrobial susceptibility testing results among them were analyzed statistically. Results A total of 6 802 pathogens were isolated from 72 783 blood culture specimens, its isolation rate was 9.3%, in which gram-negative bacilli, gram- positive cocci and fungi accounted for 57.3%, 39.9% and 2. 8% respectively. The top five species were coagulase-negative Staphylococci （ n -- 1 677, 24. 6% ） , Escherichia coli （ n = 1 099, 16.9% ）, Klebsiella pneumoniae （n = 878, 12.9% ）, Acinetobactor baumannii （n = 474, 7.0% ） and Brucella （n =361,5.3% ）. The isolation rate of Klebsiella pneumoniae was increasing year by year, its resistance rate to imipenem increased from 2.2% in 2013 to 9.9% in 2016. The isolation rate of Acinetobactor baumannii was increasing year by year, its resist- ance rate to cefoperazone/sulbactam was about 60%, to cefepime and imipenem was about80%. Conclusion It＇ s supposed measures of nosocomial infections in